Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors
Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors
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DOI：
10.1016/j.bbi.2020.07.037
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发表时间：
2020-10-01
影响因子：
15.1
通讯作者：
Benedetti, Francesco
中科院分区：
文献类型：
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作者：
Mazza, Mario Gennaro;De Lorenzo, Rebecca;Benedetti, Francesco
预防引发的免疫系统扰动可能导致精神病理学，在以前的冠状病毒爆发后观察到精神后遗症。严重急性呼吸系统综合征冠状病毒（COVID-19）大流行的传播可能与精神问题有关。我们调查了COVID-19对幸存者的精神病理学影响，同时考虑了临床和炎症预测因素的影响。我们对402名COVID-19幸存的成年人（265名男性，平均年龄58岁）进行了精神症状筛查，在医院治疗后一个月随访。临床访谈和一组自我报告问卷被用来调查创伤后应激障碍（PTSD），抑郁，焦虑，失眠，和强迫症（OC）精神病学。我们收集了社会人口统计学信息、临床数据、基线炎症标志物和随访血氧饱和度水平。很大比例的患者自我评定在精神病理学范围内：28%的PTSD、31%的抑郁、42%的焦虑、20%的OC症状和40%的失眠。总体而言，56%的患者在至少一个临床维度上得分在病理范围内。尽管基线炎症标志物水平显著较低，但女性遭受更多的焦虑和抑郁。既往精神病诊断阳性的患者在大多数精神病理学指标上的评分增加，基线炎症相似。基线全身免疫炎症指数（SII）反映了基于外周淋巴细胞、中性粒细胞和血小板计数的免疫应答和全身炎症，与随访时的抑郁和焦虑评分呈正相关。PTSD、重度抑郁和焦虑都是与残疾生活年限相关的高负担非传染性疾病。考虑到COVID-19感染对心理健康的惊人影响，目前对精神病学炎症的见解，以及目前观察到的更严重的炎症导致更严重的抑郁症，我们建议评估COVID-19幸存者的精神病理学，并深化对炎症生物标志物的研究，以诊断和治疗紧急的精神疾病。
Infection-triggered perturbation of the immune system could induce psychopathology, and psychiatric sequelae were observed after previous coronavirus outbreaks. The spreading of the Severe Acute Respiratory Syndrome Coronavirus (COVID-19) pandemic could be associated with psychiatric implications. We investigated the psychopathological impact of COVID-19 in survivors, also considering the effect of clinical and inflammatory predictors.We screened for psychiatric symptoms 402 adults surviving COVID-19 (265 male, mean age 58), at one month follow-up after hospital treatment. A clinical interview and a battery of self-report questionnaires were used to investigate post-traumatic stress disorder (PTSD), depression, anxiety, insomnia, and obsessive-compulsive (OC) symptomatology. We collected sociodemographic information, clinical data, baseline inflammatory markers and follow-up oxygen saturation levels.A significant proportion of patients self-rated in the psychopathological range: 28% for PTSD, 31% for depression, 42% for anxiety, 20% for OC symptoms, and 40% for insomnia. Overall, 56% scored in the pathological range in at least one clinical dimension. Despite significantly lower levels of baseline inflammatory markers, females suffered more for both anxiety and depression. Patients with a positive previous psychiatric diagnosis showed increased scores on most psychopathological measures, with similar baseline inflammation. Baseline systemic immune-inflammation index (SII), which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil, and platelet counts, positively associated with scores of depression and anxiety at follow-up.PTSD, major depression, and anxiety, are all high-burden non-communicable conditions associated with years of life lived with disability. Considering the alarming impact of COVID-19 infection on mental health, the current insights on inflammation in psychiatry, and the present observation of worse inflammation leading to worse depression, we recommend to assess psychopathology of COVID-19 survivors and to deepen research on inflammatory biomarkers, in order to diagnose and treat emergent psychiatric conditions.